CPT® Code 93152

Official Description

Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography

Common Language Description

The CPT® Code 93152 refers to the process of interrogating and programming an implanted phrenic nerve stimulator system during a polysomnography, which is a comprehensive sleep study. This procedure is specifically designed for patients who have a phrenic nerve stimulator implanted to treat central sleep apnea. The interrogation involves assessing the functionality of the stimulator, which is a device that helps regulate breathing by stimulating the diaphragm. During the sleep study, a healthcare professional, typically a programmer, continuously evaluates the device's performance while the patient sleeps in various positions: on their back, right side, and left side. This multi-positional assessment is crucial as it allows for the collection of data on how the stimulator performs under different conditions, which can affect the patient's breathing patterns. The programming aspect involves making necessary adjustments to the neurostimulator's parameters based on the data collected, aiming to optimize the patient's respiratory rate, pulse amplitude, duration, and the threshold at which the patient may awaken due to breathing disturbances. The adjustments are tailored to ensure that the patient experiences the least number of apneic events during sleep, thereby improving overall sleep quality and respiratory function. After the interrogation and programming, the results are thoroughly discussed with the patient, including any further adjustments that may be needed and the importance of follow-up monitoring to ensure the continued efficacy of the treatment.

1. Indications

The procedure described by CPT® Code 93152 is indicated for patients diagnosed with central sleep apnea who have a previously implanted phrenic nerve stimulator system. The following conditions warrant the interrogation and programming of the device during a polysomnography:

Central Sleep Apnea A condition characterized by repeated episodes of apnea during sleep due to a lack of respiratory effort, which can lead to disrupted sleep and decreased oxygen levels.
Evaluation of Device Efficacy To assess how well the implanted phrenic nerve stimulator is functioning in managing the patient's sleep apnea symptoms.
Need for Programming Adjustments When there is a requirement to modify the settings of the neurostimulator to enhance its performance based on the patient's response during sleep.

2. Procedure

The procedure for CPT® Code 93152 involves several critical steps to ensure the effective interrogation and programming of the implanted phrenic nerve stimulator system:

Step 1: Patient Preparation The patient is prepared for the polysomnography by ensuring that they are comfortable and informed about the procedure. Electrodes and sensors are placed to monitor various physiological parameters during sleep.
Step 2: Continuous Evaluation The programmer continuously evaluates the performance of the phrenic nerve stimulator while the patient sleeps. This evaluation occurs in three different sleeping positions: lying on the back, the right side, and the left side, allowing for comprehensive data collection on the device's efficacy across different postures.
Step 3: Data Capture Data is captured throughout the sleep study, focusing on the apnea hypopnea index and other relevant metrics that indicate the patient's breathing patterns and the effectiveness of the stimulation provided by the device.
Step 4: Parameter Adjustment Based on the data collected, the programmer makes adjustments to the neurostimulator's parameters, including respiration rate, pulse amplitude, duration, and the threshold for awakening. These adjustments are tailored to optimize the patient's breathing and minimize apneic events.
Step 5: Discussion of Results After the interrogation and programming, the results are discussed with the patient. This includes an explanation of the adjustments made, the rationale behind them, and any potential need for further modifications or follow-up monitoring to ensure ongoing effectiveness.

3. Post-Procedure

Post-procedure care following the interrogation and programming of the phrenic nerve stimulator system involves monitoring the patient's response to the adjustments made during the sleep study. Patients may be advised to keep a sleep diary to track their sleep quality and any apneic events they experience. Follow-up appointments are essential to reassess the device's performance and make any necessary further adjustments. The healthcare provider will also discuss the importance of ongoing monitoring to ensure that the phrenic nerve stimulator continues to function optimally in managing the patient's central sleep apnea.

Short Descr	INTERROG&PRGRMG IPNSS POLYSM
Medium Descr	INTERROG&PRGRMG IPNSS DURING POLYSOMNOGRAPHY
Long Descr	Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography
Status Code	Active Code
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	0 - Physician Service Code
Multiple Procedures (51)	0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50)	0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62)	0 - Co-surgeons not permitted for this procedure.
Team Surgery (66)	0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Procedure or Service, Not Discounted when Multiple
Type of Service (TOS)	5 - Diagnostic Laboratory
Berenson-Eggers TOS (BETOS)	none
MUE	1

Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.